Kids and teens who've been diagnosed with type 1 diabetes have a lot to handle - they need to eat properly, exercise regularly, test their blood sugar levels on schedule, and take the right amount of insulin. When faced with that many tasks, it's easy for teens to feel stressed. Stress can be particularly harmful for adolescents with diabetes, because it can affect hormones in the body that control blood sugar and may make it difficult for teens to stick to their diabetes management plan.
The good news is that teens with hard-to-control blood sugar levels who participate in an intense therapy program can learn to manage their diabetes better with less stress, say researchers from Wayne State University in Detroit, Michigan, and the Medical University of South Carolina in Charleston.
Researchers randomly divided 127 teens with type 1 diabetes who'd been having problems controlling their blood sugar levels into two groups. One group (the control group) received standard medical care and regularly met with diabetes specialists, nurses, social workers, dietitians, and psychologists. The teens in the other group (the intervention group) received standard care plus met with a therapist two or three times a week for about 6 months.
During the sessions (which they attended with their families), the teens had therapists help them identify problems that had been getting in the way of their blood sugar control. Over the course of the sessions, the therapists helped them overcome those obstacles with:
- Family interventions. The therapist taught parents to become more involved in monitoring their child's diabetes regimen. Parents also received training in creating family routines, establishing regular mealtimes, and communicating effectively with their teens.
- Peer interventions. Friends learned to support the teen as he or she stuck to the diabetes plan.
- School interventions. The parents and therapist met with school personnel to improve communication about the teen's diabetes care needs.
- Community interventions. The therapist helped parents and teens find ways to make ensure care for the teens' diabetes during other activities, such as during visits to extended family members.
- Health care system interventions. The therapist helped the family keep health care appointments and communicate with the diabetes health care team.
At the beginning of the study and about 7 months later, the teens in both groups completed questionnaires that measured their stress due to worries about their diabetes, their interactions with family members and friends, their responsibilities for managing their diabetes, and their symptoms of high blood sugar levels and low blood sugar levels. The teens also underwent regular tests to determine how well they were controlling their blood sugar levels.
Compared with their stress levels at the beginning of the study, teens who had the intense therapy program had significantly reduced stress after treatment. In contrast, the students in the control group had more stress than they did at the start of the study. The therapy program helped reduce stress for both younger and older teens of both genders. Overall, the therapy treatment helped teens improve their blood sugar control because it helped them adhere to their diabetes management plan more effectively.
What This Means to You: According to the results of this study, an intense therapy program of this type can help teens reduce their stress levels and improve their blood sugar control by helping them follow their diabetes management plan. If your teen is having trouble following his or her diabetes management plan, talk to your child's doctor or other member of the diabetes health care team.
Source: Deborah A. Ellis, PhD; Maureen A. Frey, PhD; Sylvie Naar-King, PhD; Thomas Templin, PhD; Phillippe B. Cunningham, PhD; Nedim Cakan, MD; Pediatrics, December 2005.
Reviewed by: Steven Dowshen, MD
Date reviewed: January 2006
